摘要
目的 研究原发性肝癌的综合性介入治疗方法和疗效。方法 对A组 38例原发性肝癌患者 ,采用经肝动脉灌注化疗栓塞术 (TACE) ,使用药物为吡柔比星 (THP) 5 0mg +丝裂霉素 (MMC)10mg +卡铂 (CBP) 30 0mg+超化碘油。 3～ 5次疗程后 ,全部病人在CT引导下行激光消融术。与B组38例原发性肝癌患者 ,仅行经肝动脉灌注化疗栓塞术。使用药物也为THP5 0mg +MMC10mg +CBP30 0mg+超化碘油 ,行 3～ 8个疗程。治疗后复查二组患者的CT、甲胎蛋白 (AFP)值及肝功能。结果 A组治疗后肿瘤完全坏死率为 85 4 %。 32例AFP值升高的患者 ,2 8例下降 ,3例不变 ,1例上升。治疗后第 1、2年生存率分别为 10 0 %、81 5 %。B组治疗后肿瘤完全坏死率为 4 1 6 % ,2 8例AFP值升高患者中 ,下降 12例 ,不变 5例 ,上升 11例。治疗后第 1、2年生存率分别为 6 8 4 %、39 4 %。两组肿瘤完全坏死率、AFP值的下降情况及第 1、2年生存率的差异均有显著意义 (其相应P值皆为0 0 0 1)。结论 TACE联合激光消融术能有效地提高原发性肝癌的治疗效果 ,是 1种值得推广的肝癌治疗的新模式。
Objective To study a comprehensive interventional treatment method for primary hepatocellular carcinoma (HCC), and to evaluate its effect.Methods 76 patients with primary HCC were divided into 2 groups randomly.38 of them (Group A)were treated with THP 50 mg+MMC 10 mg+CBP 300 mg+iodized oil by transcatheter artery embolization (TAE) combined with laser ablation under CT scan guidance for 3～5 courses, while the other 38 patients (Group B)were treated with THP 50 mg+MMC 10 mg+CBP 300 mg+iodized oil by TAE only for 3～5 courses.The serum AFP, ALT, AST, TBIL, BUN, and Creatinine, and CT scan were acquired before and after the treatment.Results The complete necrosis rate of group A was 85.4%.Among the 32 patients with elevated AFP, the AFP descended after treatment in 28 cases, remained unchanged in 3, and elevated in 1.The survival rates of the 1st and the 2 nd year were 100% and 81.5%, respectively.The complete necrosis rate of group B was 26.4%.Among the 28 patients with elevated AFP, the AFP descended after treatment in 12 cases, remained unchanged in 5, and elevated in 11.The survival rates of the 1st and 2nd year were 68.4% and 39.4%, respectively.There were significant statistical differences between the two groups (P value were 0.001) regarding the tumoral necrosis, AFP, and survival rates.Conclusion TAE combined with laser ablation could effectively improve the treatment effect of primary HCC.It is a new treatment mode for primary HCC and is worth extending.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2004年第6期587-591,共5页
Chinese Journal of Radiology
关键词
经肝动脉栓塞化疗
激光消融术
联合
治疗
原发性肝癌
Carcinoma,hepatocellular
Catheter ablation
Lasers
Chemoembolization, therapeutic
